MPIP: Melanoma Patients Information Page

The MPIP is the oldest and largest community of people affected by melanoma hosted through the Melanoma Research Foundation. It is designed to provide support and information to caregivers, patients, family and friends. Once you have been touched by melanoma—either as a patient or as a family member or friend of a patient—you become part of a community. It is not a community anyone joins willingly. But if you must be part of this group, you will find no better place to find the tools you need in your journey with this cancer, and the friends who can make that journey more bearable.

The information on the bulletin board is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

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luv4scjjt's picture
Replies 4
Last reply 3/28/2015 - 11:49pm

Hello everyone..I am new to MRF...New to melanoma as well..I was diagnosed in Jan about a week after my birthday. I went to the doc to check out a weird (ingrown hair like bump) on my leg. I nicked it with my razor while shaving and it didn't stop bleeding all day. next morning i called doc to have it looked at. What i thought was an ingrown hair (no color just skin colored bump) turned out to be nodular melanoma. Let the doctor appts begin.....Since then i have had the excision 4cm circumference...the skin graft...thigh was donor sight....and the sentinel lymph node biopsy..which oddly enough almost killed me..lol. I had an acute anaphylactic shock to the die and crashed on surgery table while they were doing the biopsy..Luckily i was still under anesthesia..I didn't feel a thing..lol. Well the results came back that my lymph node was clear..I was very happy and excited and thought that would be the end of doc apt's seen as i was clear. Then i had fallow up with my oncologist and my heart sank.. I still have to do the interferon treatments. Well not have too..... but strongly recommended. The size of my nodule was 4mm. So he is strongly recommending i go through with the treatments because with nodular melanoma i guess their is a high reoccurrence rate. I am very glad that i am only doing this as a precaution and not because it has spread but of course i am worried about treatment. I am 40 by the way. I am healthy (except for this) so i am sure i will be ok. But i am still worried about side effects...Does everyone get the side effects with interferon or is it some do some don't kind of thing? What are the real chances of it coming back if i do or don't do interferon? Of course i am scared and i hope you all can give me experienced honest answers. I don't need things sugar coated. Truth is best for me.....good and bad. What am i looking at?????

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BrianP's picture
Replies 3
Last reply 3/28/2015 - 4:51pm
Replies by: _Paul_, Mat, Maureen038

Some of you might remember the thread from last July talking about living with stable disease. 

http://www.melanoma.org/find-support/patient-community/mpip-melanoma-patients-information-page/living-stable-disease-g-samsa#comment-77579

This article in Psychology Today reminded me of that thread.  I thought it was a really well done article and is so applicable to many of us on this forum.

https://www.psychologytoday.com/articles/201503/the-new-cancer-survivors

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BrianP's picture
Replies 2
Last reply 3/28/2015 - 11:24am
Replies by: Ed Williams, Bubbles

A little background. I'm a pilot and unfortunately due to my stage IV melanoma dx in May 2012 I lost my FAA medical. Last week marked my one year anniversary of stable disease. I was told by a doctor that one year of stability and no new mets would be the absolute minimum the FAA would accept if they were to approve my medical. I think it's a long shot at best but I feel great and I'm optimistic about the future so I thought I would go ahead and submit a request to get my medical back. The worst that can happen is they say no. What I wanted to ask is if anyone has seen any data or charts on Anti-PD1 drugs which gives an indication that if you make it to the one year mark your chances of recurrence are greatly reduced.  Due to the drug being so new I’m not sure the data is mature enough to be able to draw that conclusion.  The only thing I’ve seen that somewhat shows the durability is from a Dr. Hodi presenation (page 8 lower left).

http://tatcongress.org/wp-content/uploads/2014/05/140305-hodi.pdf

Thanks for input anyone might have.

Brian

 

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Replies by: Bubbles, Aundrea

Dr. Weber talked to me about this upcoming trial when I had my last checkup and it is now listed on the ClinicalTrials.gov site.  Not yet recruiting...but here's the deal if you're interested: 

http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/03/new-ipi-vs-nivo-trial-for-resected.html

It would certainly have been a trial I would have signed up for back in 2010 when I needed it!!!  I wish you all my best!  Celeste

 

chaoticallypreciselifeloveandmelanoma.blogspot.com

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Eileensulliv's picture
Replies 8
Last reply 3/28/2015 - 6:16pm

It's been an interesting week. Since a week after my first infusion of Yervoy and Nivolumab at Hopkins, I was getting intermittent high fevers, nausea and vomiting, and a few other minor side effects. My onc said we are going to delay my second treatment until I get rid of the fevers. Then last week they became not so intermittent at all... Ended up in my local ER Thursday night, and sent home after some fluids, anti nausea meds, and Tylenol. Friday morning I wake up with 103.3 fever and vomiting, so it was off to Hopkins I went. I have never stayed in a hospital before, so I was a bit nervous, but their staff and nurses are exceptional, and made me feel right at "home"! 

I pretty much stumped the doctors as to why they couldn't get my fevers and nausea to go away. They tried the beta blockers again, and stopped after two days. They tried three days of IV antibiotics and no change. Every test and ct came back as normal. So they chalked this one up to a side effect of treatment, and started me on steroids (on day 2 of antibiotics) and just like that, I'm on the mend! The last night of fevers was no fun... 103.5 most of the night, and nurses packing ice packs all around my body every half an hour... Minor bump in the road, and a week's "vacation" in a fantastic hospital. 

However, my onc says he is extremely hesitant about keeping me on the trial, as he does not want to put my body through this again. He is thinking we will just stick to the Nivolumab, but I will meet with him Monday to discuss my options. I would prefer to stay on the trial, but I do know that Nivolumab alone is a very good option. Now that I'm feeling better than I have in weeks, I'm just ready to get this show on the road again!

Eileen 

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Medscape Medical News Oncology

Nick Mulcahy

March 24, 2015

Pembrolizumab (Keytruda, Merck) has bested ipilimumab (Yervoy, Bristol-Myers Squibb) in the treatment of advanced melanoma in a head-to-head clinical trial, according to an announcement today from Merck.

Pembrolizumab demonstrated a statistically significant and "clinically meaningful" improvement in overall and progression-free survival, compared with ipilimumab, the company reports.

The randomized phase 3 study, known as KEYNOTE-006, will be stopped early on the recommendation of an independent Data Monitoring Committee.

The complete data will be presented in the opening plenary session at the American Association of Cancer Research annual meeting in April.

Ipilimumab is currently the standard of care in the first-line treatment of advanced melanoma.

Pembrolizumab is already approved for use in patients with advanced or unresectable melanoma who are no longer responding to other drugs, including ipilimumab and BRAF inhibitors (in patients whose tumors expressBRAF V600). This indication received accelerated approval on the basis of tumor response rate and durability of response.

The new clinical trial pitted two different monoclonal antibody treatment strategies against one another; the programmed death (PD) inhibitor pembrolizumab was compared with the cytotoxic T-lymphocyte antigen 4 (CTLA-4)-blocking antibody ipilimumab.

Pembrolizumab is now the first anti-PD-1 therapy to demonstrate a survival advantage over the standard of care for the first-line treatment of advanced melanoma, according to Merck.

"Evidence from our clinical program for pembrolizumab will help to define the appropriate treatment of advanced melanoma," Roger Perlmutter, MD, PhD, president of Merck Research Laboratories, said in a press statement.

KEYNOTE-006 is a global open-label study of patients with unresectable stage III or IV advanced melanoma who have received no more than one previous systemic therapy.

In the three-group study, 834 patients were randomized to receive pembrolizumab 10 mg/kg every 3 weeks, pembrolizumab 10 mg/kg every 2 weeks, or four cycles of ipilimumab 3 mg/kg every 3 weeks.

 

The coprimary end points were progression-free survival and overall survival; secondary end points were overall response rate, duration of response, and safety, with an exploratory analysis for health-related quality of life.

At week 12 and every 6 weeks thereafter per RECIST 1.1, tumor response was assessed with an independent central blinded radiographic review and investigator-assessed immune-related response criteria.

 

Live 4 today. Thank God for all he has done for us. Looking forward to enjoying tomorrow.

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mizmena's picture
Replies 1
Last reply 3/28/2015 - 7:47am
Replies by: Fen

As if it cant get any worse...more crappy news...so ready to get these scans done...i pray that its not other places...

Final Surgical Pathology Report

Final Pathologic Diagnosis RIGHT AXILLARY LYMPH NODE (NEEDLE CORE BIOPSY)-

Metastatic melanoma, with surrounding fibrosis and lymphoid tissue. See comment.

COMMENT There is known history of malignant melanoma, and, in the appropriate context, the current findings are compatible with lymph node metastasis. In addition, molecular profiling analysis has been ordered. Correlation with clinical and imaging findings is recommended.

Gross Description

Specimen A is received in formalin labeled “Burnett, Melinda Ann” and “right axilla palpable”. It consists of multiple friable tan tissue cores ranging from 0.1 to 1.5 cm long and each measuring 0.1 cm in outer diameter. The specimen is submitted in A1. One blue marker included.

Microscopic Description

Microscopic examination reveals fibrosis and lymphoid tissue with metastatic melanoma. Areas of necrosis are noted. Immunoperoxidase staining for S100, Melan-A, and HMB-45 highlights the metastatic melanoma. MCK staining is negative. CD3 and CD20 highlight the background T-cells and B-cells, respectively.

 

blah...so glad i found this group to help me on this journey. This is a foreign language to me.

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Speedster's picture
Replies 2
Last reply 3/27/2015 - 9:57am
Replies by: Aundrea

Have an ideas for support here in Austin as I'm just getting strarted having be diagnosed in January.  I am tying to naviagte the emotional side of things as I make the turn toward a clinical trial in Dallas at Baylor Sammons.  I'm Stage IIIc.  Ugh.

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Replies by: JP.2000, _Paul_

Journey DX, a patient research company, is working with patient advocacy group Canadian Skin Patient Alliance (CSPA) on research to understand the potential impact of pembrolizumab on the patient experience.

The research will be used as part of the CSPA patient input submission, to advocate for provincial coverage of pembrolizumab in Canada, so that patients may have access to this drug without paying for it out-of-pocket.

We are conducting telephone interviews (30-45 minutes) with:

1) Individuals from Canada or the US who have been in a pembrolizumab trial

2) caregivers for individuals who have been in a pembrolizumab trial

Absolutely no names or identifying information will be reported.

A compensation of $50 will be provided to those who participate, in appreciation of their time.

If you would like to be involved or would simply like more information, please contact Dr. Jennifer Pereira, Research Director of Journey DX (jennifer.pereira@journeydx.com, 416-485-7387).

Thank you very much for your consideration.

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Anonymous's picture
Anonymous
Replies 2
Last reply 3/26/2015 - 3:05pm
Replies by: Anonymous, Janner

Has anyone ever heard of this test?   Thoughts?  I'm currently 1b dx june 2014, although I try hard to put it out of my mind and know that my chances of never dealing with melanoma again are excellent.  It' lurks in the back of my mind, what if??   

 

http://skinmelanoma.com/know-your-risk/know-your-metastic-risk/

 

Know Your Metastatic Risk
An accurate prognosis can have significant impact on post-operative care

 

About 60,000 people are diagnosed each year with early stage, non-metastatic melanoma. Some of them will go on to develop aggressive metastatic disease. In fact, according to the American Cancer Society, 3% of Stage IA, and 9% of IB tumors will turn deadly within 5 years. In addition, 19% of Stage IIA, 30% of IIB, and 47% of IIC melanomas will likely prove fatal over a 5-year period.

The DecisionDx-Melanoma™ test is designed to identify the Stage I and II patients whose tumor biology suggests they are at higher or lower risk of metastasis than their stage might indicate. The test uses sophisticated technology to measure the “expression” or activity of specific genes known to play a role in metastasis, and classifies tumors as either Class 1, with a 3% chance of spreading within 5 years, or Class 2, with a 69% risk of metastasis.

Gene testing is an advance made possible by breakthroughs in genomic, or personalized, medicine. While staging categories (I-IV) are based on the outcomes of large groups of patients whose cancer shared similar characteristics (tumor thickness, mitotic rate, ulceration, presence in the lymph nodes, etc.), gene testing analyzes an individual’s own tumor tissue to estimate their metastatic risk. This “individualized” information, in combination with staging, can help doctors and early stage patients better determine how aggressively to monitor, and in some cases, treat their disease.

It’s important to talk to you doctor to decide if the gene test is right for you. To guide the discussion, download the “Talk to Your Doctor” guide.

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Replies by: JimsWife, rosa1, Patina, Issy

Hi y'all, I've been browsing this board for a few months and am so thankful it exists. Hoping you guys can weigh in and lift my spirits.
A little background: My husband Jim is 34, Army National Guard veteran - 14 years of service, 2 tours overseas to Afghanistan and Iraq. He was diagnosed on 12/23/14 as stage IV with multiple brain, lungs, and bone mets (in his lower spine, left hip and femur) BRAF and PTEN positive. Primary diagnosis was a mole on his right temple in 2007, that was removed.
He had SRS in January to 11 lesions in his brain, then another MRI revealed there were 20+, so he had whole brain radiation in February. He also took Temodar during this time. After a couple weeks break, he started the braf/mek combo on 3/2. The side effects were mild until recently. He now has a nightly low fever, chills, headache, loss of appetite and fatigue. It seems to be getting worse and I'm so worried. Smoking pot doesn't help the appetite anymore and he just started cannabis oil 5 days ago.
I should add we've only been married 19 months and I'm 25 weeks pregnant with our first child. This has been so hard to deal with but lately I've been having a really hard time, especially now that I can tell he feels so bad. I hate this disease so much and what it's doing to him and our life. Any positivity would be appreciated :)

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Julie in SoCal's picture
Replies 9
Last reply 3/27/2015 - 10:51pm

Hi there friends!

 

Yes we need some good news!  After seemingly forever (ok, only 3 weeks!) I now have a new date to start treatment. It's taken a lot of wrangling between Rock Star Doc's office, my insurance company and Merck, but I've finally gotten a date to begin Pembro!  I start on Monday afternoon.  Also, because of all the insurance denials and foot dragging (and the fact that I don't make a lot of money), Merck has accepted me into their access program and I'll get it free for a year.  AMAZING!!!!

 

So grateful!

Julie

Stage 3c: WLE, SNB, LND, HD-INF, GM-CSF, IPI, PEMBRO.

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tony9511's picture
Replies 7
Last reply 3/27/2015 - 2:20pm

Hi I am one of the victims of this terrible disease.  I was diangonosed with Melanoma, hade local WLE Surgery, and less than a year later it came back and spread to the lymph nodes in my neck.  I know my survival rate is not good, especially with it coming back so soon.  I did the interferon for one year and it was pure hell on me.  A few months past my last injection of interferon, my body hurts just as bad in fact worse than my year on melanoma.  I have major pain in my bones and my joints.  My question is does anybody know or experienced this?  Thank you so much I anxiously await responses.  I am a 41 year old male.  Also does having it come back so quickly affect my survival rate?   Tony

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Ken Burns has a documentary film based on the book “Cancer, The Emperor of All Maladies”

http://cancerfilms.org/

It will be on PBS March 30, 31 and April 1 at 8:00 pm (CT).

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